Hari Om Singh Sengar1, Kailash Charokar2, Prashant Nema3
BACKGROUND
The method adopted for incision closure has an influence on the outcomes of
wound healing. The study was conducted to compare the ‘mass closure’ method
with the conventional layer closure, and to find out the suitable surgical closure
method for midline laparotomy incision.
METHODS
A prospective comparative study was conducted at a tertiary care teaching
institute over a period of 2 years. Patients > 14 years of age, who were operated
on by midline laparotomy incision, were included in the study group (N = 60).
Either a ‘mass closure’ or the conventional layer closure method was adopted as
per the operating surgeon’s choice. Based on the method used the cases were
allocated into two groups, each with 30 patients. In the ‘mass closure’ group
(Group A), continuous suturing was used in 22 patients and interrupted closure in
8 patients. In the ‘layered closure’ group (Group B), the abdomen was closed in
layers using absorbable suture for the peritoneum (together with transversalis
fascia) and non-absorbable for the linea alba. The patients were followed up postoperatively,
and for 6 months after discharge from the hospital in follow-up for
the detection of the wound complications.
RESULTS
The mean age of patients in Group A was 40.9 ± 15.48 years, and 41.03 ± 14.73
in Group B. There were 25 males and 5 females in Group A and 23 males and 7
females in Group B. Closure time of incision was significantly lower in the mass
closure group (P < 0.05). The postoperative complications in Group A was 20 %
(Seroma-1 patient, infection-3, partial wound dehiscence-1, and hernia-1). In
Group B, the overall complication rate was 36 % (Seroma-3 patients, infection-5,
burst abdomen- 1, hernia- 2).
CONCLUSIONS
Mass closure method is better than the conventional layer closure for the midline
laparotomy incision.
